Beware of those exotic nuts!

More nuts (actually they are seeds from a botanical standpoint) can trigger food allergic reactions:

Hazelnut: Corylus avellana is also known as filbert nut or cobnut. They are very common in the U.S. diet and used to make pralines, nutella spread and Frangelico liqueur. It only takes about 0.29 mg to trigger an allergic reaction. Hazelnut allergy is common and can range from Oral Allergy Syndrome with mouth itching in those patients with birch pollen allergy to more severe, anaphylactic reactions. While Turkey produces the most hazelnuts in the world (and hazelnut allergy affects 1.7% of their population), in the U.S. hazelnuts are produced in Oregon and Washington (3rd largest producer).

Brazil nut: Bertholletia excels come from trees in South America with the biggest supplier being Bolivia followed by Brazil and Peru. It is illegal to cut down Brazil nut trees in Brazil and the large, heavy fruit (4.4 lbs) has been known to fall from the trees damaging cars, injuring people with 1 death from a Brazil nut landing on a person’s head. Allergy to Brazil nuts is relatively common and can lead to fatal anaphylactic reactions. Brazil nuts share a cross reactive protein with walnuts and severe reactions can occur even with allergy skin testing. Multiple health benefits may be related to ingesting Brazil nuts, but they also contain 1000X more radium, a radioactive agent, than any other food. Brazil nuts are the second most common nut allergy in the UK.

Coconut: Cocos nucifera belongs to the Palm family. The coconut is not a true nut, but a seed. The Philipines and Indonesia are the top coconut producers in the world. Despite a low prevalence of allergies to coconut in the U.S., the U.S. Food and Drug Administration (FDA) identified coconuts in October 2006 to be included on food labels. Coconut is one of the top-five food allergies in India where it is a common food source. In the U.S., severe allergic reactions are rare and in a survey by the Food Allergy and Anaphylaxis Network only 4 cases of coconut allergy were reported from over 5100 people (mostly children). Rashes from coconut-derived oil and extracts used in soaps, shampoos and hair conditioners are more frequently reported. Coconut shares some protein similarities with lentil, walnut and hazelnut.

Shea nut: Nuts from the Shea tree from Africa are typically not eaten, but the natural fat extracted from them is commonly used in cosmetics, hair care products, lotions and moisturizers. In the food industry, sometimes shea butter is a substitute for cocoa butter in chocolate manufacturing. Since Shea nuts are recognized by the FDA as a nut, they are included in food labels. However, shea nut butter does NOT contain detectable protein (cause of allergic reactions) and allergic reactions to shea nut butter have not been reported.

Pine nut: These are the edible seeds of pine trees. About 20 species of pine trees have seeds large enough to harvest. In the U.S., pinyon pines are the most common pine tree where the seed are harvested. Allergic reactions to pine nuts are not common but can be severe with 80% of reactions being severe. Most people allergic to pine nuts are not allergic to other nuts. Pine nuts are used in preparing pesto. “Pine Nut Syndrome” or “Pine mouth,” first described in 2001, is when a bitter metallic taste persists after eating pine nuts. Symptoms can last up to 2 weeks.

At Family Allergy Asthma & Sinus Care, we will assist you in diagnosing and treating food allergies including exotic nut allergies. While some nut allergies are uncommon, they can still be severe.